有牙槽嵴吸收表现的牙周炎患者上前牙龈乳头缺陷程度的相关因素研究

Study on the Factors Related to the Defect Degree of Upper Gingival Papilla in Periodontitis Patients with Alveolar Ridge Absorption

目的:研究有牙槽嵴吸收表现的牙周炎患者上前牙龈乳头缺陷程度的影响因素。方法:选取2019年3月1日-2020年12月12日于笔者医院接受治疗的有牙槽嵴吸收表现的20例牙周炎患者的73个上前牙龈乳头作为研究对象。将所有上前牙龈乳头根据龈乳头缺陷程度分为无缺陷组、轻度缺陷组、中度缺陷组和重度缺陷组。借助标准化临床图像以及锥形束CT扫描结果,对邻接触点到骨嵴顶距离(Distance from contact point to bone crest,CP-BC)以及邻面釉质牙骨质界到骨嵴顶距离(Distance from proximal cemento-enamel junction to bone crest,pCEJ-BC)进行评价。同时评价骨嵴顶水平的根间距(Distance between roots,RD),骨嵴顶水平龈乳头高度(Height of gingival papilla,PH),骨嵴顶水平颊舌向骨宽度(Width of bone crest,BCW),临床附着丧失(Clinical attachment loss,CAL)。分析各组上述指标的差异,并以Spearman相关性分析明确各项指标和上前牙龈乳头缺陷程度的关系。结果:结果显示,73个上前牙龈乳头中,无缺陷20个,轻度缺陷26个,中度缺陷19个,重度缺陷8个。CP-BC及pCEJ-BC均随上前牙龈乳头缺陷的严重程度呈逐渐升高趋势,且经单因素方差分析可知,各组间比较差异有统计学意义(均P<0.05)。上前牙龈乳头中度缺陷组、重度缺陷组的BCW均高于无缺陷组,而PH均低于无缺陷组,差异均有统计学意义(P<0.05)。经Spearman相关性分析可得:CP-BC、pCEJ-BC及BCW均和上前牙龈乳头不同缺陷程度呈正相关关系,而PH和上前牙龈乳头不同缺陷程度呈负相关关系(均P<0.05)。结论:CPBC、pCEJ-BC及BCW、PH均是有牙槽嵴吸收表现的牙周炎患者上前牙龈乳头缺陷程度的影响因素,值得临床重点关注。

Objective To investigate the influencing factors of the degree of anterior gingival papilla defects in patients with periodontitis with alveolar crest absorption.Methods Seventy-three upper gingival papillae of 20 periodontitis patients with alveolar ridge absorption who were treated in the author's hospital from March 1,2019 to December 12,2020 were selected as the study objects.All upper gingival papillae were divided into no defect group,mild defect group,moderate defect group and severe defect group according to the degree of gingival papillae defect.The distance from contact point to bone crest(CP-BC)and distance from proximal cemento-enamel junction to bone crest(PCEJ-BC)were evaluated using standardized clinical images and cone-beam CT scan results.The distance between roots(RD),height of gingival papillaheight of gingival papilla(PH),width of bone crest(BCW),clinical loss of attachment(CAL).at the bone crest level were also evaluated.The differences of the above indexes in each group were analyzed,and the relationship between each index and the degree of anterior gingival nipple defect was determined by Spearman correlation analysis.Results In 73 anterior gingival papillae,20 had no defects,26 had mild defects,19 had moderate defects,and 8 had severe defects.Both CP-BC and pCEJ-BC showed a gradually increasing trend with the severity of the defects of the upper gingival papilla,and the one-way analysis of variance showed that there were statistically significant differences among all groups(allP<0.05).The BCW in the moderate defect group and the severe defect group was higher than that in the non-defect group,and the PH was lower than that in the non-defect group,with statistical significance(P<0.05).Spearman correlation analysis showed that CP-BC,PCEJ-BC and BCW were positively correlated with different degrees of defects of the anterior gingival papilla,while PH was negatively correlated with different degrees of defects of the anterior gingival papilla(all P<0.05).Conclusion CP-BC,PCEJ-BC,BCW and PH are the influencing factors of the degree of anterior gingival papilla defect in patients with periodontitis combined with alveolar crest absorption,which is worthy of clinical attention.